Complete Care Medical Group Professional Corporation

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

COMPLETE CARE MEDICAL GROUP PROFESSIONAL CORPORATION

Practice address

4902 Irvine Center Dr Ste 103
Irvine, CA 92604-3334

Phone

(949) 861-4177

Fax

(949) 861-4178

NPI assigned

Apr 5, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kristi Jolliffe

Title

Practice Manager

Phone

(949) 861-4177

Specialties & licenses 1

Addresses

Other names 1

• Complete Care Medical Group Doing business as

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shawn Hwang Hamilton, MD

  • Internal Medicine Physician
  • Irvine, CA
  • NPI 1134270069
  Medicare reassignment NPD
• Alexandra Huber

  • Nurse Practitioner
  • Yorba Linda, CA
  • NPI 1669178232
  Medicare reassignment NPD
• Alison Lynn Gracom, PA

  • Medical Physician Assistant
  • Irvine, CA
  • NPI 1245496843
  Medicare reassignment
• Susan Christine Biegel, M.D.

  • Internal Medicine Physician
  • Upland, CA
  • NPI 1710956412
  NPD
• Tiffany P Zaken, PA-C

  • Medical Physician Assistant
  • Brea, CA
  • NPI 1780228445
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643932800000",
    "number": "1912586306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4902 IRVINE CENTER DR STE 103",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926043334",
            "telephone_number": "949-861-4177",
            "fax_number": "949-861-4178"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4902 IRVINE CENTER DR STE 103",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926043334",
            "telephone_number": "949-861-4177",
            "fax_number": "949-861-4178"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE CARE MEDICAL GROUP PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-05",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A",
        "authorized_official_last_name": "JOLLIFFE",
        "authorized_official_first_name": "KRISTI",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "949-861-4177"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Irvine",
            "affiliation": "N",
            "address_1": "4902 Irvine Center Dr Ste 103",
            "city": "Irvine",
            "state": "CA",
            "country_code": "US",
            "postal_code": "926043334",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Complete Care Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Complete Care Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Internal Medicine Physician in Irvine, CA
• Providers in Irvine, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.